{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T20:07:05Z","timestamp":1760386025768,"version":"3.40.5"},"reference-count":20,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2024,8,12]],"date-time":"2024-08-12T00:00:00Z","timestamp":1723420800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["HIV Medicine"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>The issue of whether integrase inhibitors (INSTIs) may confer a higher risk of paradoxical tuberculosis\u2010related immune reconstitution inflammatory syndrome (TB\u2010IRIS) compared with other classes of antiretroviral in people with HIV with a profound level of immunosuppression remains insufficiently explored. We aimed to assess whether such a higher risk exists by examining a cohort of patients with TB\u2010HIV initiating antiretroviral therapy (ART) in Hong Kong.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a retrospective review of 133 patients registered in the TB\u2010HIV Registry of the Department of Health during the period 2014\u20132021.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Sixteen of 70 patients (22.9%; 95% confidence interval [CI] 13.0\u201332.7) and 14 of 63 patients (22.2%; 95% CI 12.0\u201332.5) from the INSTI and non\u2010INSTI groups experienced TB\u2010IRIS (<jats:italic>p<\/jats:italic>\u2009=\u20090.920). The median intervals between ART initiation and IRIS among patients from the two groups were similar (3\u2009weeks [interquartile range IQR 2.0\u20137.8] vs. 4\u2009weeks [IQR 2.0\u20135.1],<jats:italic>p<\/jats:italic>\u2009=\u20090.620). The proportion of patients requiring steroid therapy were similar, as were the hospitalization rates. There was no IRIS\u2010related death in either group. The risk of TB\u2010IRIS with INSTI versus non\u2010INSTI was also similar in a stratified analysis in a subgroup of patients with a baseline CD4 count of &lt;50\u2009\u03bcL (10\/33 [30.3%; 95% CI 14.6\u201346.0] vs. 10\/22 [45.5%; 95% CI 24.7\u201366.3],<jats:italic>p<\/jats:italic>\u2009=\u20090.252) and another subgroup of patients with ART initiated within 4\u2009weeks of anti\u2010TB treatment (10\/26 [38.5%; 95% CI 19.8\u201357.2] vs. 10\/23 [43.5%; 95% CI 23.2\u201363.7],<jats:italic>p<\/jats:italic>\u2009=\u20090.721).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our cohort study did not offer support for an increased risk of TB\u2010IRIS with INSTIs compared with non\u2010INSTIs, even in severely immunocompromised people with HIV.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hiv.13695","type":"journal-article","created":{"date-parts":[[2024,8,13]],"date-time":"2024-08-13T05:00:09Z","timestamp":1723525209000},"page":"1270-1276","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["No increased risk of tuberculosis\u2010related immune reconstitution inflammatory syndrome with integrase inhibitor\u2010based antiretroviral therapy in people with<scp>HIV<\/scp>\u00a0with profound immunosuppression"],"prefix":"10.1111","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6819-1961","authenticated-orcid":false,"given":"Chi Kuen","family":"Chan","sequence":"first","affiliation":[{"name":"Department of Health Tuberculosis and Chest Service, Public Health Services Branch, Centre for Health Protection Hong Kong China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shan Shan","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Health Tuberculosis and Chest Service, Public Health Services Branch, Centre for Health Protection Hong Kong China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ka Hing","family":"Wong","sequence":"additional","affiliation":[{"name":"Department of Health Special Preventive Programme, Public Health Services Branch, Centre for Health Protection Hong Kong China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chi Chiu","family":"Leung","sequence":"additional","affiliation":[{"name":"Hong Kong Tuberculosis Chest and Heart Diseases Association Hong Kong China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Man Po","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Medicine Queen Elizabeth Hospital Hong Kong China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tak Yin","family":"Tsang","sequence":"additional","affiliation":[{"name":"Department of Medicine Princess Margaret Hospital Hong Kong China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chun Kwan Bonnie","family":"Wong","sequence":"additional","affiliation":[{"name":"Department of Health Special Preventive Programme, Public Health Services Branch, Centre for Health Protection Hong Kong China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shuk Nor","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Health Tuberculosis and Chest Service, Public Health Services Branch, Centre for Health Protection Hong Kong China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wing Sze","family":"Law","sequence":"additional","affiliation":[{"name":"Department of Health Tuberculosis and Chest Service, Public Health Services Branch, Centre for Health Protection Hong Kong China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lai Bun","family":"Tai","sequence":"additional","affiliation":[{"name":"Department of Health Tuberculosis and Chest Service, Public Health Services Branch, Centre for Health Protection Hong Kong China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,8,12]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40262-020-00898-8"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1215541"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1002706"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)60084-2"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0b013e31828ace69"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)60917-9"},{"volume-title":"Updated Recommendations on First\u2010Line and Second\u2010Line Antiretroviral Regimens and Post\u2010Exposure Prophylaxis and Recommendations on Early Infant Diagnosis of HIV: Interim Guidelines. 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